SUMMARIES FOR PATIENTS
Can Special Cholesterol Tests Help Predict a Person's Risk for Atherosclerosis?
3 May 2005 | Volume 142 Issue 9 | Page I-38
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The summary below is from the full report titled "Advanced Lipoprotein Testing Does Not Improve Identification of Subclinical Atherosclerosis in Young Adults: The Bogalusa Heart Study." It is in the 3 May 2005 issue of Annals of Internal Medicine (volume 142, pages 742-750). The authors are W.S. Tzou, P.S. Douglas, S.R. Srinivasan, W. Chen, G. Berenson, and J.H. Stein.
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What is the problem and what is known about it so far?
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Atherosclerosis is a thickening of blood vessel walls caused in part by cholesterol buildup. Atherosclerosis takes years to develop and may not cause problems unless extreme narrowing occurs or a blood clot suddenly blocks blood flow. With either of those events, a heart attack, stroke, or other problems can develop. Ultrasound scanning of neck (carotid) arteries can detect atherosclerosis in its early stages before it causes complications. Cholesterol that builds up in carotid arteries travels within protein spheres called lipoproteins. Routine cholesterol testing measures the cholesterol carried by two of these lipoproteins but does not consider their sizes or other lipoproteins that may be present. Lipoprotein sizes and the cholesterol in other lipoproteins can now be measured by special testing. It is not clear how special cholesterol testing compares with routine testing for predicting atherosclerosis in carotid arteries.
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Why did the researchers do this particular study?
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To see if special cholesterol tests are better than routine tests for predicting atherosclerosis.
236 adults between 20 and 38 years of age. All lived in Bogalusa, Louisiana, and were participants in the Bogalusa Heart Study. The study began in 1973 to see how atherosclerosis develops in young people.
The researchers collected blood samples for routine cholesterol tests and one type of special cholesterol test (density-gradient ultracentrifugation). They performed carotid artery ultrasonography to detect atherosclerosis and compared the ability of the routine and special test to predict atherosclerosis seen on the ultrasound.
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What did the researchers find?
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The special cholesterol test used in this study was no better than routine tests for predicting atherosclerosis.
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What are the limitations of the study?
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The study was performed in young adults who were free of disease, and the data were analyzed at one point in time. The findings may not apply to older adults, who are at higher risk for atherosclerosis and its complications. The findings do not address how special tests compare with routine tests for predicting complications over time. Also, several methods can be used for special cholesterol testing, and these findings may not apply when other methods are used.
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What are the implications of the study?
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A special cholesterol test was no better than routine tests for predicting atherosclerosis in young adults. The findings need to be confirmed using other testing methods. The role of special tests for predicting complications still needs to be determined.
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